Double Dose of Hepatitis B Vaccine Increases Antibody Response in Chronic HCV Patients

Efficacy of standard dose can be suboptimal in patients with hepatitis C, study shows.

Patients with hepatitis C virus (HVC) who were non-responders to a single dose of hepatitis B virus (HBV) vaccine experienced increased antibody response when given a double dose of the vaccine, according to the results of a recent study.

The study, published in the February 2014 edition of the International Journal of Preventive Medicine, targeted HCV patients whose liver disease could become more severe if they were to contract acute HBV infection. Since various studies have found that immunogenicity of HBV vaccination is decreased in some HCV patients, the researchers aimed to evaluate the efficacy and safety of a double dose of HBV vaccine.

A recent report in the Annals of Internal Medicine estimated that 130 to 170 million people worldwide currently suffer from chronic HCV infection, with 500,000 deaths each year attributed to the disease. To improve the survival rate and overall quality of life for HCV patients, the new study notes that prevention of HBV super infection is recommended for a subset of HCV patients who carry a high risk of exposure to HBV, particularly patients with chronic HCV. Exposure to HBV can exacerbate HCV severity and increase the risk of liver cirrhosis and hepatocellular carcinoma.

The immunogenicity of the HBV vaccine is reduced in liver transplant recipients or patients with chronic liver disease, the authors note. To examine the impact of a double dose of the HBV vaccine, the researchers divided 64 patients with chronic HCV infection into 2 groups at random, with half receiving a standard dose and the other half receiving a double dose. A control group was also established with 32 healthy individuals.

The results indicated that while the efficacy of the standard dose of HBV vaccination in HCV patients was suboptimal, a double-dose vaccination increased antibody response with no major adverse events reported. Among chronic HCV patients who received a standard dose, there were 4 non-responders (12.5%), while the response rate was 100% in chronic HCV patients who received a double dose of the vaccination as well as in the control group, whose members received a standard dose. As a result, the authors write that using a double dose of the HBV vaccine appears to be an effective method for increasing the response rate.